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Review
. 2019 Apr 15;11(4):848.
doi: 10.3390/nu11040848.

International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): Contributions to Understanding the Global Obesity Epidemic

Peter T Katzmarzyk  1 , Jean-Philippe Chaput  2 , Mikael Fogelholm  3 , Gang Hu  4 , Carol Maher  5 , Jose Maia  6 , Timothy Olds  7 , Olga L Sarmiento  8 , Martyn Standage  9 , Mark S Tremblay  10 , Catrine Tudor-Locke  11
Affiliations
Review

International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): Contributions to Understanding the Global Obesity Epidemic

Peter T Katzmarzyk et al. Nutrients. .

Abstract

The purpose of this review is to summarize the scientific contributions of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) in extending our understanding about obesity in children from around the world. ISCOLE was a multi-national study of 9 to 11 year-old children from sites in 12 countries from all inhabited continents. The primary purpose was to investigate relationships between lifestyle behaviors and obesity, and the influence of higher-order characteristics such as behavioral settings, and physical, social and policy environments. ISCOLE has made several advances in scientific methodology related to the assessment of physical activity, dietary behavior, sleep and the neighborhood and school environments. Furthermore, ISCOLE has provided important evidence on (1) epidemiological transitions in obesity and related behaviors, (2) correlates of obesity and lifestyle behaviors at the individual, neighborhood and school levels, and (3) 24-h movement behaviors in relation to novel analytical techniques. A key feature of ISCOLE was the development of a platform for international training, data entry, and data quality for multi-country studies. Finally, ISCOLE represents a transparent model for future public-private research partnerships across low, middle and high-income countries.

Keywords: collaboration; epidemiological transition; overweight; pediatric.

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Conflict of interest statement

The authors declare no conflicts of interest. With the exception of requiring that the study was global in nature, the funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Principal component loadings for the healthy and unhealthy diet pattern scores in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) (all sites combined), from Mikkila et al. [25].
Figure 2
Figure 2
Income gradients in obesity prevalence across levels of HDI in (A) girls and (B) boys from ISCOLE. Low, middle and high human development index (HDI) correspond to the 10th, 50th and 90th percentiles of the ISCOLE sample (HDI = 0.52, 0.72 and 0.91, respectively). Tests for linear trend are indicated: * p < 0.05; ** p < 0.001; *** p < 0.0001. Figure is adapted from Broyles et al. [32].
Figure 3
Figure 3
Mean dietary pattern scores across ISCOLE study sites. (A) presents the mean scores for the “healthy dietary pattern” and (B) presents the mean scores for the “unhealthy dietary pattern”. Data were obtained from Mikkila et al. [25].
Figure 4
Figure 4
Ternary plot of the average proportions of the 24-h day spent in sleep (bottom axis), sedentary behaviour (left axis) and total physical activity (right axis) in the 12 ISCOLE countries. The black bars represent the range of time (h/day) spent in the various movement behaviours. For sedentary behavior, follow the direct horizontal line to the left axis; for physical activity, follow the lines sloping upwards from left to right to the right axis; for sleep, follow the lines sloping downwards from left to right to the bottom axis. Chinese (CHN) children, for example, spend on average 37% of the day sleeping, 40% of the day sedentary and 23% in physical activity. Compositional means are from Dumuid et al. [70]. AUS = Australia; BRZ = Brazil; CAN = Canada; CHN = China; COL = Colombia; ENG = England; FIN = Finland; IND = India; KEN = Kenya; POR = Portugal; RSA = Republic of South Africa; USA = United States.
Figure 5
Figure 5
Association between moderate-to-vigorous physical activity (MVPA) and obesity. (a) shows the correlation between average MVPA and obesity, while (b) shows the correlation between MVPA inequality (Gini coefficient) and obesity. Boys and girls are combined for analysis. Correlation coefficients were compared using a Steiger’s Z-test (p = 0.029), adapted from Chaput et al. [84].
See this image and copyright information in PMC

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